Baclofen

From WikEM
Jump to: navigation, search

Administration

  • Type: Muscle relaxant/anti-spasmodic
  • Dosage Forms:
  • Routes of Administration: oral, intrathecal
  • Common Trade Names:

Adult Dosing

  • 5-20mg PO 3-4 times/day
  • maintenance intrathecal rate after titration: 22 to 1400 mcg/day

Pediatric Dosing

  • 2-7yo: 10 to 15 mg/day PO in 2-3 divided doses, titrate to max 40mg/day in 3-4 divided doses
  • >7 yo: 10 to 15 mg/day PO in 2-3 divided doses, titrate to max 60mg/day in 3-4 divided doses
  • <12 yo: maintenance intrathecal rate after titration- 24 to 1199 mcg/day

Special Populations

Renal Dosing

  • CrCl 50-80 mL/min: reduce dose by 1/3
  • CrCl 30-50 mL/min: reduce dose by 1/2
  • CrCl <30 mL/min: reduce dose by 2/3
  • If HD, use intrathecal with caution, likely reduce dose

Hepatic Dosing

  • No adjustment

Contraindications

  • Allergy to class/drug

Adverse Reactions

Serious

  • GI bleed
  • Coma
  • Seizure
  • Aseptic meningitis
  • Pneumonia
  • Withdrawal

Common

  • Hypotension
  • Nausea/vomiting, constipation
  • Dizziness, somnolence, asthenia, poor muscle tone
  • Urinary complications

Pharmacology

  • Half-life: 5 hours (oral), 1.5-4 hours (intrathecal)
  • Metabolism: Hepatic (15%)
  • Excretion: Mostly renal

Mechanism of Action

  • GABA agonist

Comments

See Also

References

Authors

Claire